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Thursday, May 16, 2013

Guest post: Maternity leave, or lack thereof

I am a psychiatry intern currently about to have my first baby towards the beginning of my second year. I feel so blessed to have this baby, who we recently found out is a girl. I am not the emotional pregnant lady everyone speaks of--just so so happy about our family's future. It took me a long time to decide to do psychiatry, and when I wasn't sure if I would have kids in residency, I thought of ob-gyn. Now, seeing how accepting and supportive my program has been of my pregnancy, I am happy with my decision.

But, there are a few things they can't change, and they have made that clear to me. For example, if I want to fast-track into child psychiatry, which I do wish to do as the fourth year curriculum at my program isn't ideal, I absolutely cannot take more than 35 days off during my second year. This includes all vacation and sick time. After some deliberation with the program director, we have come to decide that I will be taking my four weeks of vacation, plus 10 days sick time, to make a total of 6 weeks maternity leave. This leaves me with 5 days of baby sick time or emergencies for the entire remainder of my second year.

While I am okay with this scenario, and actually it's more than I expected to have in residency, I grow more and more bitter towards the field of medicine. Family and friends are always so shocked when they hear about the above "maternity leave." My friends in finance always fire back with, "What! So-and-so at my job got pregnant and had 4 months paid maternity leave, without using vacation." Gosh, wouldn't that be so nice. When MIL heard about the maternity leave, she couldn't believe it. Her response was, "But that's not fair!" Who's to decide what's fair?

I am beginning to think more and more about simply extending the residency and doing a fourth year as much as I don't want to. It's an easy call free year and I may like to have the time to spend with my little daughter. However, with looming debt over our heads, I would really like to be able to make an attending salary sooner.

Some that read this post may think, "Wow you are lucky, that is a great amount of time!" But I don't feel lucky to have to pass my baby on at 6 weeks. I don't feel lucky that I'll be taking a lot of call while my baby is an infant. Or that after much hard work, I still have to squeeze pennies to buy baby stuff.

17 comments:

I did an ER residency and was able to have 3 months maternity leave, and thankfully it was paid. I had to make up all 3 months though so didn't finish residency with the rest of my class. I still was able to keep my vacation days, but there's really no such thing as taking a sick day in ER, so it made sense for our family for my husband to stay home with our baby. I have a lot of friends in other specialties that only took 6 weeks maternity leave, giving up vacation and sick days but didnt have to make any time up. For me it was worth it, and I enjoyed the 3 months I had at home with my little girl. Sometimes medicine doesnt make motherhood easy, but hang in there! It will all work out in the end whichever path you decide.

It isn't just medicine. As a postdoctoral fellow in Biomedical research, I only had six weeks worth of paid maternity leave (which included all my vacation and sick days) and we could not afford having the unpaid leave because my husband was a student. It was very difficult, but I just had to send my child to daycare at six weeks. Fortunately we found a place where the child to provider ratio for infants was 2:1. I don't have any advice on your current situation, but just wanted to let you know that six weeks is the norm rather than the exception. All the best in making your decision.

It isn't just medicine. As a postdoctoral fellow in Biomedical research, I only had six weeks worth of paid maternity leave (which included all my vacation and sick days) and we could not afford having the unpaid leave because my husband was a student. It was very difficult, but I just had to send my child to daycare at six weeks. Fortunately we found a place where the child to provider ratio for infants was 2:1. I don't have any advice on your current situation, but just wanted to let you know that six weeks is the norm rather than the exception. All the best in making your decision.

I agree it's not just medicine. It's the whole US that has sucky maternity leave policies. We have strict rules during training because of ACGME, but even for non-residents out in the working world, there really is no maternity leave policy. There's FMLA, which allows up to 12 weeks UNPAID leave, but you only qualify if you're a full time worker. There is no such thing as guaranteed paid maternity leave. So yeah, it sucks.

With my first child, I took 8 weeks off (had to do clinic and a "reading rotation" for 4 weeks) but still had to make up 2 weeks at the end of residency. With my second child (private practice) I took 8 weeks off (4 weeks part time) and it was paid. With this third child (different private practice) I will take 8 weeks off (4 weeks part time) but any time off is unpaid. So yeah, totally sucks.

I highly encourage you to consider delaying your training a bit--take the leave that you think you need now and worry about fellowship later. I had my first child part way through 2nd year of anesthesiology residency and had no vacation time for the remainder of the year. It was rough to say the least--managing a resident schedule with call and essentially no time away from work while dealing with a baby who wasn't sleeping through the night. With my 2nd, I insisted on and was granted the opportunity to take an additional 4 weeks (unpaid) leave on top of 6 weeks paid time . This worked out much better-actually had some vacation time to look forward to after returning to work (not so much vacation time for travelling, but just a week here or there to get my sanity back). I ended up finishing residency plus fellowship 16 weeks "late", but in the end who cares? I got a part time job that I LOVE, the money takes care of itself eventually (let's face it--all of us in medicine are used to some degree of delayed gratification), and I was a much happier resident/fellow. If I had it to do over again, I would definitely have taken some unpaid time with my first and saved some vacation to use after I returned to work. Good luck with your decision!

6 weeks is definitely not enough. Perhaps you are being pressured because you are still very early in your training. Medicine will always be there and your baby's first years are most important for attachment etc etc I'm sure you know all the theories. Medicine is hard on mum but so are many other walks in life. Just have to prioritize. Baby comes first.

6 weeks is norm in most residencies simply bc you can miss up to 6 weeks without having to make up any time according to acgme (for 3+ yrs residencies). 6 weeks sucks. I got 6 weeks plus took 2 weeks of vacation so I could keep my other 2 weeks "just in case" during my fellowship. 8 weeks sucks. With number 2, I was attending and took 12 weeks (paid!). 12 weeks sucks. It all sucks.

We're told we can have "it all" but in reality, while we can have parts of "it all," something has to give, sleep, staying-at-home, full-time, relationships (not just with spouses), hobbies, television, something gives.

6 weeks is norm in most residencies simply bc you can miss up to 6 weeks without having to make up any time according to acgme (for 3+ yrs residencies). 6 weeks sucks. I got 6 weeks plus took 2 weeks of vacation so I could keep my other 2 weeks "just in case" during my fellowship. 8 weeks sucks. With number 2, I was attending and took 12 weeks (paid!). 12 weeks sucks. It all sucks.

We're told we can have "it all" but in reality, while we can have parts of "it all," something has to give, sleep, staying-at-home, full-time, relationships (not just with spouses), hobbies, television, something gives.

6 weeks is norm in most residencies simply bc you can miss up to 6 weeks without having to make up any time according to acgme (for 3+ yrs residencies). 6 weeks sucks. I got 6 weeks plus took 2 weeks of vacation so I could keep my other 2 weeks "just in case" during my fellowship. 8 weeks sucks. With number 2, I was attending and took 12 weeks (paid!). 12 weeks sucks. It all sucks.

We're told we can have "it all" but in reality, while we can have parts of "it all," something has to give, sleep, staying-at-home, full-time, relationships (not just with spouses), hobbies, television, something gives.

6 weeks is norm in most residencies simply bc you can miss up to 6 weeks without having to make up any time according to acgme (for 3+ yrs residencies). 6 weeks sucks. I got 6 weeks plus took 2 weeks of vacation so I could keep my other 2 weeks "just in case" during my fellowship. 8 weeks sucks. With number 2, I was attending and took 12 weeks (paid!). 12 weeks sucks. It all sucks.

We're told we can have "it all" but in reality, while we can have parts of "it all," something has to give, sleep, staying-at-home, full-time, relationships (not just with spouses), hobbies, television, something gives.

The US in general sucks for leave. Medicine is particularly tough because the ACGME basically makes being creative to get a longer leave virtually impossible during training and training spans the bulk of your reproductive years. I took 6 weeks and it was ok. My son is 17 months old and we're plenty bonded despite this shorter leave. It'll all work out.

I worked as a full time professor not tenured (i.e. basically contract with health benefits- no leave or vacation paid at a glorious yearly salary of about 40,000) and it sucked for me too. I went back to work 2 weeks post a c section. I wasn't working 80 hours a week, more like 40-45 awaybfrom home at 15 at home but it was still work, and it still sucked.No advice just a voice of understanding. My kids still love me and don't appear to be screwed up at all (yet). I managed, it was far from ideal, but we made it.

8 weeks for me for each kid (I was allowed two extra because they let me start a month early) was miserable - mainly because I had no vacation for three years, having both kids during residency. I do remember being kind of excited to go back to the adult world, even though I was missing the hell out of my daughter, then son. I felt very isolated on maternity leave - the bonding and the nursing was wonderful but I luckily had great help in place coming to my home when I went back and a decent residency lifestyle that had me home before dinner most days. So the double role worked out for me, I think better than staying longer. That's just my personality. Well, another month or two might have been better:)

I hope I don't sound like a terrible person but it all worked out. My kids at 10 and almost 8 are great, and I spend lots more time with them in private practice. I know people who decided to quit that miss medicine although feeling fulfilled in their jobs as SAHM, and I know people who went part-time and felt much more happy seeing all the "milestones" in their 2nd or 3rd baby's lives after missing them in residency. There's going to be regrets and pulls at the heart no matter what you choose. When you make major decisions, try to do it confidently and live mostly in the present and future. Good luck to you!

It basically comes down to you deciding what your priority is. I added a year to my medical training when my 1st child was born and have never regretted it (I am now a 3rd yr peds resident and have 3 kids). Did it cost me financially in the long run? Yes, but kids are expensive anyway, so it's again back to priorities. Did it cost me professionally? No, nothing that I have noticed anyway. You just have to make the best decision you can now. I will say that prior to actually having my child, I felt like I could just push through, but after he was born, I knew I would never be able to be gone from him that much and decided to "decelerate". So be prepared for your priorites to change or magnify after delivery. Maybe you could see how you end up feeling on your maternity leave? Not sure if your program would be able to be flexible w/ that since residency scheduling is usually pretty tight and done far in advance. Plus maybe you'll even end up having baby #2 during a 4th year :)

I am a PMR doctor and I have been blessed with two wonderful boys. Rounding, doing procedures, busy office' schedules, working on weekends while you’re pregnant it is not fun. You won’t get any special treatment for being pregnant. I am not allowed to have any paid time off or maternity because I only get what I work/produce. We truly don’t have it easy... but girls it is all worth it!. My little one is only 5 month all, and I am actually writing this before staring my Saturday rounds. I just want to finish my work and go back home and play with my kids .... and who knows, maybe do it all over again later on

I am a college student who is trying to get on track to become an OB/GYN. But there's one question I have- I intend to have a family eventually? What is the general range for maternity leave for OB/GYN's and how does the process work? Am I going to be fired if I have a baby? Answers please!

Mothers in Medicine is a group blog by physician-mothers, writing about the unique challenges and joys of tending to two distinct patient populations, both of whom can be quite demanding. We are on call every. single. day.

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